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As Dogs Waste Away, Owners Seek Answers

Michele Daniels of Point Pleasant, N.J., with her dog, Jackie, now recovered from E.P.I., a digestive illness that researchers are seeking to better understand.Credit

A few years ago, Michele Daniels’s puppy, Jackie, suddenly became sick with constant, messy stomach problems. As Jackie, a 9-month-old German shepherd, rapidly lost 20 pounds, Ms. Daniels, who lives in Point Pleasant, N.J., spent many sleepless nights caring for her dog and worrying.

“The lowest point was getting up during the night probably five or six times and taking her out with diarrhea,” said Ms. Daniels, 51, a client services representative at a veterinarian’s office. “We were watching her fade away in front of us, and we couldn’t do anything about it.”

After visiting several veterinarians, Jackie finally received a diagnosis of exocrine pancreatic insufficiency, or E.P.I., a disorder in which the pancreas does not produce enough enzymes to properly digest food and absorb nutrients. A similar disorder occurs in people, including those with cystic fibrosis, celiac disease or chronic pancreatitis, and both people and pets often take the same enzyme-rich dried pork pancreas in powder or capsule form to treat it.

Ms. Daniels, who initially feared that her dog would have to be put down, added pancreatic enzymes to her pet’s diet, along with vitamin B12 injections, then watched as her dog improved after several months of treatment. “I feel like she has been given the life she was meant to have,” she said, fighting off tears.

Researchers are currently trying to determine the genetic cause behind exocrine pancreatic insufficiency in dogs and searching for better treatment options. The fact that it is most common among German shepherds indicates that there is a hereditary component to the disease, said Dr. Leigh Anne Clark, an assistant professor of genetics at Clemson University, where researchers are working to identify a genetic marker that could be used by breeders to identify dogs at risk. About half of all cases occur in other breeds, including Chihuahuas, terriers and beagles, and it occurs less frequently in cats.

Genetic testing has become more common for pets in recent years. There are already at least 80 DNA tests available to detect disease-related genes in dogs, from narcolepsy in Labrador retrievers to early-onset, hereditary cataracts in Boston terriers. Breeders are now using the information to identify dogs that carry the faulty genes and make sure they do not pass them on to future generations by eliminating them from the breeding pool.

There are quite likely multiple genetic and environmental factors that contribute to E.P.I., Dr. Clark said. While the disease was first observed in dogs 150 years ago, she has noticed an increased awareness of the illness in recent years. At a recent dinner with friends who are veterinarians, she asked whether any of them had been treating the condition.

“I had them go around the table, and every one of them had an E.P.I. case – 10 years ago that wasn’t the case,” she said.

There are no official statistics on the number of pets with the disorder. But Dr. Jorg Steiner, director of the gastrointestinal laboratory at the College of Veterinary Medicine at Texas A&M University, estimates that E.P.I. is diagnosed in 8,000 dogs in the United States each year, and says that the number of cases will most likely rise as awareness of the disease grows.

Dr. Steiner is conducting clinical trials on a new enzyme that would be easier for dogs with the disease to digest — and less costly for pet owners. The current options for owners who have dogs with E.P.I. can be expensive. A 12-ounce bottle of powdered enzymes can cost about $200 and often lasts less than two months, depending on a dog’s size and the dosage.

The main online resource about the disease — www.epi4dogs.com — gets about 15,000 page views a month, according to Olesia Kennedy, who created the Web site after her own dog struggled with the illness. A simple blood test by a veterinarian can determine whether a dog has the disease, she said, and treatments can be tailored to the individual pet, usually some combination of pancreatic enzymes, a low-fiber diet, antibiotics and vitamin B12 shots that must be given on a continuing basis.

Some pet owners report improvements after feeding their dogs a completely raw diet of unprocessed food that includes antibiotic-free meat and organic produce.

Dr. Sandy Willis, a veterinary internal medicine specialist who works with the American Veterinary Medical Association, said the E.P.I. Web site was a good resource for pet owners. Although most veterinarians know about the disease, she said, it might not be the first one they test for, and pet owners who suspect their animal might have the disease might speed the diagnostic process by mentioning it to their veterinarians.

Last year, Kelli Grant, who works at a molecular diagnostic company and lives in San Antonio, became alarmed when her 3-year-old Shetland sheepdog, Addie, developed bad diarrhea and lethargy and quickly dropped from a healthy 38 pounds to a skeletal 26. When Ms. Grant called the dog’s breeder, she was “devastated” to learn that Addie’s mother had been put down because of a similar problem.

After a veterinarian diagnosed E.P.I., Ms. Grant started Addie on pancreatic enzymes and B12 shots at home. Since then, she has learned that it is possible to manage the disease without spending a fortune. A year later, the dog has “put the weight back on,” Ms. Grant said. “She’s super happy and plays Frisbee.”